Secondary biliary cirrhosis as a consequence of graft-versus-host disease.
A 9-yr-old white girl with acute monoblastic leukemia received an HLA-identical, mixed lymphocyte culture-nonreactive bone marrow transplant from her sister. Twelve days after the transplant, a diffuse, pruritic, maculopapular rash involving the entire body surface (including the palms and soles) developed. Subsequent skin biopsy was consistent with cutaneous graft-versus-host disease, and biopsy-proven hepatic involvement manifested by severe, unremitting cholestatic jaundice soon followed. The patient's biliary status as monitored by serial liver biopsies demonstrated progression from chronic graft-versus-host disease to cirrhosis, culminating in death secondary to liver failure 25 mo after transplant.
Stechschulte
D J
DJ
Department of Pathology, University of Kansas School of Medicine, Kansas City.
Fishback
J L
JL
Emami
A
A
Bhatia
P
P
D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D007948:Leukemia, Monocytic, Acute / Q000601:surgery; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000209:etiology* / Q000473:pathology